COVID-19 Pandemic Research Articles

Impacts, Adaptations, and Preparedness Among SNAP-Ed Implementers During the COVID-19 Pandemic: A Multistate Study

Objective: The study examines: 1) impacts of COVID-19 on the work of Supplemental Nutrition Assistance Program – Education (SNAP-Ed) implementers, 2) facilitators and barriers experienced in making adaptations, and 3) factors that would have helped with preparedness to adapt. Design, Setting, and Participants: A purposive sample of 181 SNAP-Ed program implementers from across five states completed a survey or interview based on the study aims. Quantitative data was summarized with descriptive statistics and qualitative data was analyzed thematically. Results: Direct education activities were found to be most impacted during COVID-19 while working to change policies, systems, and environments and indirect education were less impacted. Both positive and negative impacts surfaced. Respondents were most likely to say they were moderately or slightly prepared to make adaptations. Elements of internal organizations, technology, and partners both helped and hindered adapting. Pre-established virtual capacity, formal preparation and planning protocols and procedures, and better and more frequent communication with partners and program leadership would have helped with preparedness. Conclusion: SNAP-Ed needs assessment and implementation processes should integrate and expand upon the lessons learned in the study to enhance future emergency preparedness among program implementers. Program policy should be updated to allow for implementation flexibility during future emergencies.

Housing conditions and COVID-19 in Barcelona: do they change by gender?

Evidence has linked poor housing conditions to negative health outcomes. However, in urban contexts characterized by social vulnerability and population-level inequalities, the gender perspective is often overlooked, despite evidence showing that housing conditions impact men and women differently in terms of health. This study aimed to describe the association between housing conditions and the prevalence of COVID-19 among men and women in Barcelona, Spain. An observational cross-sectional study was conducted using the 2021 Barcelona Health Survey. The study population consisted of non-institutionalized residents over 14 years of age in Barcelona. The survey was administered to a sample of 3,545 participants during the COVID-19 pandemic, between February 2021 and February 2022. Crude and adjusted prevalence ratios of COVID-19 (aPR), along with 95% confidence intervals (95% CI), were estimated using multivariate Poisson regression models with robust variance. The analysis was stratified by gender. A significant gradient was observed across age groups for both men and women, with higher COVID-19 prevalence in younger categories. The prevalence was notably higher among individuals born in low-income countries, particularly for women (aPR 1.62). We also identified a significant association between housing conditions, vulnerability factors, and COVID-19 prevalence in both men and women. Living with four or more cohabitants was associated with higher prevalence (aPR 1.96 for women and 1.89 for men), as was the presence of dampness in the home (aPR 1.34 for women and 1.27 for men). Additionally, energy poverty was significantly associated with higher COVID-19 prevalence in women (aPR 1.36), but not in men. This study highlights the association between housing conditions and COVID-19 in Barcelona, with a pronounced impact on young people, women from low-income countries, and women experiencing energy poverty.

Serving with Values in Challenging Times: Exploring Institutional Leaders' Values Work at Local Level During COVID-19

While existing literature mostly analyzes public leaders' pandemic responses, limited attention has been paid to local government leaders in terms of values work. This study examines the values created and infused by senior managers who serve as institutional leaders in local governments during the COVID-19 pandemic. Focusing on the data collected from the responses of the sample set, the study aims to illuminate the processes of creating and infusing values among senior managers of a metropolitan municipality in Türkiye. For this aim, interviews were conducted with 11 senior managers of this metropolitan municipality. The findings produced within the scope of two propositions firstly reveal three types of value created for, and infused into the organization: personal, organizational, and service-related. Secondly, the study identifies the uniform process devoted to values work among senior managers and reveals that there are no significant differences in the styles of creating and infusing values (i.e., values work) among managers at different levels of local government in challenging times.

Characterization of novel ACE2 mRNA transcripts: The potential role of alternative splicing in SARS-CoV-2 infection.

The human angiotensin converting enzyme 2 (ACE2) gene encodes a type I transmembrane protein, which is homologous to angiotensin I-converting enzyme (ACE) and belongs to the angiotensin-converting enzyme family of dipeptidyl carboxypeptidases. As highlighted by the COVID-19 pandemic, ACE2 is not only crucial for the renin-angiotensin-aldosterone system (RAAS), but also displays great affinity with the SARS-CoV-2 spike protein, representing the major receptor of the virus. Given the significance of ACE2 in COVID-19, especially among cancer patients, the present study aims to explore the transcriptional landscape of ACE2 in human cancer and non-cancerous cell lines through the design and implementation of a custom targeted long-read sequencing approach. Bioinformatics analysis of the massive parallel sequencing data led to the identification of novel ACE2 mRNA splice variants (ACE2 sv.7-sv.12) that demonstrate previously uncharacterized exon-skipping events as well as 5' and/or 3' alternative splice sites. Demultiplexing of the sequencing data elucidated the differential expression profile of the identified splice variants in multiple human cell types, whereas in silico analysis suggests that some of the novel splice variants could produce truncated ACE2 isoforms with altered functionalities, potentially influencing their interaction with the SARS-CoV-2 spike protein. In summary, our study sheds light on the complex alternative splicing landscape of the ACE2 gene in cancer cell lines, revealing novel splice variants that could have significant implications for SARS-CoV-2 susceptibility in cancer patients. These findings contribute to the increased understanding of ACE2's role in COVID-19 and highlight the importance of considering alternative splicing as a key factor in viral pathogenesis. Undoubtably, further research is needed to explore the functional roles of these variants and their potential as therapeutic targets in the ongoing fight against COVID-19.

Exploring the attitudes and experiences of Hungarian primary care physicians on the utilisation of digital health solutions.

During the COVID-19 pandemic, digital health solutions ensured the continuity of care especially in primary healthcare practices. COVID-19 accelerated the adoption of digital health solutions. The aim of this study is to describe the digital health-related attitudes and experiences of Hungarian Primary Care Physicians (PCPs) and also analyse the socio-demographic effects on digital health attitudes among PCPs. This study used a quantitative and qualitative mixed methodological approach to examine the digital health-related attitudes and experience of Hungarian PCPs. As part of the "E-physicians and E-patients in Hungary" survey, we conducted an online survey among medical doctors working in Hungary between July 2021 to May 2022. A total of 1,774 questionnaires were received, consisting of 1,576 medical doctors and 198 dentists. Among the medical doctors there were 415 primary care physicians (PCPs). In addition to the online questionnaire survey, qualitative research in the form of semi-structured interviews with doctors was also conducted. These interviews took place between October 2021 and June 2022. A total of 62 interviews were conducted,19 with PCPs. Primary care physicians are more open to technologies that facilitate communication and collaboration with patients, while showing less interest in technologies that support clinical work. Of the demographic variables (age, gender, type of settlement), age was found to have the most significant effect on digital health knowledge, use and intended use. Both the interviews and the multivariate analysis indicate that individuals with greater knowledge, expertise, and experience are more likely to perceive the advantages of digital solutions. This highlights the importance of training, especially given the significant aging population among Hungarian primary care physicians, who may not be accustomed to using these tools naturally. The way PCPs perceive patient expectations regarding the use of digital health tools has a significant impact on the PCPs' use and intended use of digital tools. When looking at perceived patient needs among PCPs the effect of age and municipality type of PCPs is significant. As age increases, the perception of patient needs decreases (from 5.02 to 4.47), and by municipality type, the average number of perceived needs decreases as one moves from larger cities to smaller municipalities (from 4.85 to 4.14). Digital health solutions have the potential to enhance the work of PCPs, but successful implementation requires addressing specific needs, demographic differences, and challenges faced by PCPs. Development of infrastructure, education, and institutional support is necessary to ensure more efficient and higher-quality healthcare delivery through the use of digital technologies.

Investigating DNA damage caused by COVID-19 and influenza in post COVID-19.

The SARS-CoV-2 virus (termed COVID-19) was responsible for over 34 million global deaths. Although the COVID-19 pandemic has subsided, infection by emerging mutant variants of SARS-CoV-2 poses a continuing threat to public health. COVID-19 infection has been associated with the development of cytokine storm syndrome, hypercoagulability, immunological dysregulation and direct viral invasion of organs, and the long-term consequences for the health of COVID-19 survivors are currently unknown. Our research focuses on the possible mutagenic aspects of infection by COVID-19 and measures their harmful effects on DNA composition. DNA damage was investigated, using the comet assay method, during two periods: in the epidemic peak of COVID-19 and during the post-COVID-19 period, both in patients infected with COVID-19 and in those with influenza. During the epidemic peak, the levels of DNA damage ranged from the highest to the lowest levels in the following groups, respectively: intubated-ICU, non-intubated-ICU, non-ICU, and influenza, with a discernible increase in DNA damage in ICU-treated patients. The levels of DNA damage in the post-COVID-19 period were significantly lower compared to those in the epidemic peak period but there was still a discernible increase in DNA damage in the ICU group. Our results indicate that levels of DNA damage may be an effective indicator in prognostic decision-making and may therefore help to reduce mortality. Given that DNA damage and impaired repair processes can contribute to chronic diseases like diabetes, cancer, and neurodegenerative conditions, it will be crucial to investigate potential similar effects in patients with COVID-19.

Survey of Citizens' Preferences for Combined Contact Tracing App Features During a Pandemic: Conjoint Analysis.

During the COVID-19 pandemic, an increased need for novel solutions such as digital contact tracing apps to mitigate virus spread became apparent. These apps have the potential to enhance public health initiatives through timely contact tracing and infection rate reduction. However, public and academic scrutiny has emerged around the adoption and use of these apps due to privacy concerns. This study aims to investigate public attitudes and preferences for contact tracing apps, specifically in Japan, using conjoint analysis to examine what specifications the public values most in such apps. By offering a nuanced understanding of the values that citizens prioritize, this study can help balance public health benefits and data privacy standards when designing contact tracing apps and serve as reference data for discussions on legal development and social consensus formation in the future. A cross-sectional, web-based questionnaire survey was conducted to determine how various factors related to the development and integration of infectious disease apps affect the public's intention to use such apps. Individuals were recruited anonymously by a survey company. All respondents were asked to indicate their preferences for a combination of basic attributes and infectious disease app features for conjoint analysis. The respondents were randomly divided into 2 groups: one responded to a scenario where the government was assumed to be the entity dealing with infectious disease apps (ie, the government cluster), and the other responded to a scenario where a commercial company was assumed to be this entity (ie, the business cluster). Samples of 500 respondents from each randomly selected group were used as target data. For the government cluster, the most important attribute in scenario A was distributor rights (42.557), followed by public benefits (29.458), personal health benefits (22.725), and profit sharing (5.260). For the business cluster, the most important attribute was distributor rights (45.870), followed by public benefits (32.896), personal health benefits (13.994), and profit sharing (7.240). Hence, personal health benefits tend to be more important in encouraging active app use than personal financial benefits. However, the factor that increased motivation for app use the most was the public health benefits of cutting infections by half. Further, concern about the use of personal data collected by the app for any secondary purpose was a negative incentive, which was more significant toward app use compared to the other 3 factors. The findings suggest that potential app users are positively motivated not only by personal health benefits but also by contributing to public health. Thus, a combined approach can be taken to increase app use.

Longitudinal assessment of cardiovascular risk factors in medical students at a Federal University in Brazil: comparison of data before and after the COVID-19 pandemic

Longitudinal assessment of cardiovascular risk factors in medical students at a Federal University in Brazil: comparison of data before and after the COVID-19 pandemic

“Whenever I help her, I am also expecting her vagina in return”: a qualitative analysis to explore men’s and adolescent girls’ perceptions of the impact of the COVID-19 pandemic on the sexual behaviour and health of adolescent girls in rural western Kenya

IntroductionThe COVID-19 pandemic caused school closures, which intensified the negative sexual and reproductive health (SRH) of adolescent girls in sub-Saharan Africa (SSA), including increases in transactional sexual partnerships, gender-based violence,...

Completion and reporting of COVID-19 clinical trials registered on ClinicalTrials.gov during the first 6 months of the pandemic: cohort study

BackgroundEarly in the COVID-19 pandemic, numerous clinical trials were initiated. Although concerns were raised regarding the quality of the trials, the eventual research output yielded from the trials remains unknown....

Integrating an Ethics Advisory Committee Into Public Health Response: A Case Study of COVID-19, Infection Prevention and Control, and Essential Work in the United States.

A lack of infection prevention and control protections for essential industries in the United States led to increased risk and incidence of COVID-19 among essential workers during the COVID-19 pandemic. When the nation deems an industry essential during a disease outbreak, an ethical obligation exists to safeguard the health of workers who are at increased risk of being exposed to disease. The Global Center for Health Security at the University of Nebraska Medical Center began work to rapidly develop and disseminate infection prevention and control guidance for essential industries, such as meat processing. The Global Center for Health Security established an ethics advisory committee to support COVID-19 response efforts. The ethics advisory committee supported the development of guidance on infection prevention and control to promote justice, reciprocity, health, safety, and equity for workers in the meat processing industry. Our experience highlighted the fundamental role of ethical analysis in public health response efforts, but ethical analysis in this case required an interdisciplinary approach, including the need for effective community-relevant solutions. The integration of an ethics committee into public health emergency response efforts can address ethical concerns for workers in industries that must remain operational during public health emergencies.

COVID-19 pandemic, climate change and indigenous knowledges informing the future of social work

COVID-19 pandemic, climate change and indigenous knowledges informing the future of social work

Intensifying Substance Use Trends among Youth: A Narrative Review of Recent Trends and Implications.

Substance use among adolescents and young adults remains a critical public health concern, with patterns shifting dramatically in recent years. This narrative review examines trends in substance use behaviors during and following the COVID-19 pandemic. Epidemiologic evidence shows declines in the proportion of youth who are using most substances but intensified consumption patterns with rising levels of disorder among adolescents who use substances. This picture may reflect the greater potency, availability and accessibility of substances, vulnerabilities related to poor mental health, minoritization, as well as social factors including pandemic stressors, commercial and regulatory forces - in short, features of the agent (substance), host (person), and environment (context), consistent with a public health formulation. Understanding trends in youth substance use and related problems, especially in the context of contributing factors, is critical for informing clinical care strategies and public health interventions to improve outcomes for youth across diverse populations.

The Rise of FLiRT Variants in the COVID-19 Pandemic: What We Know So Far.

The Rise of FLiRT Variants in the COVID-19 Pandemic: What We Know So Far.

How Right Now/Qué Hacer Ahora: Findings from an evaluation of a national mental health and coping campaign amidst the COVID-19 pandemic.

Beyond its physical health impact, the COVID-19 pandemic also resulted in grief from loss of loved ones, isolation due to social distancing, stress, fear, and economic distress-all of which impacted mental health. How Right Now/Qué Hacer Ahora (HRN) is an award-winning, national campaign that provides emotional support to people disproportionately affected by COVID-19. We conducted a theory-based, culturally responsive evaluation to assess the campaign's effect on coping behaviors and resiliency between summer 2020 and spring 2021. We surveyed HRN's priority audiences (older adults/caregivers and those with preexisting health conditions, experiencing violence, or economic distress) in English and Spanish using NORC's national probability panel, AmeriSpeak, over three waves. We also analyzed social media data and monitored HRN website traffic and triangulated these data to understand the campaign's full impact. Campaign exposure was associated with people who were experiencing higher levels of stress and were more likely to seek information to support their emotional well-being. Campaign exposure was also positively associated with increased feelings of resilience and confidence in using coping strategies, especially for people experiencing violence or economic distress and people from racial and ethnic groups. Findings demonstrate the campaign's success in reaching its intended audiences with the mental health support they needed. Additionally, the HRN evaluation's design illustrates how the use of multiple data sources can elucidate a deeper understanding of campaign impact. Findings underscore that culturally responsive health communication interventions-like HRN-can provide needed mental health support and resources to disproportionately affected communities. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Antibiotic consumption patterns in older adults: a comparative study of people 65 years and older in and outside nursing homes, Belgium, 2016 to 2022.

BackgroundInappropriate antimicrobial consumption (AMC) drives the emergence of antimicrobial resistance. Institutionalised, older populations are associated with antimicrobial treatments of longer duration and broader spectrum than recommended, higher rates of multidrug-resistant infections and poorer outcomes for resistant infections. Yet systematic, national monitoring of AMC in nursing home (NH) residents is lacking.AimTo perform a retrospective analysis of antibiotic consumption in Belgian NHs, we compared analogous populations inside and outside NHs. We aimed to provide a blueprint for establishing surveillance of NH AMC, based on national reimbursement data.MethodsThe National Institute for Health and Disability Insurance supplied reimbursement AMC data for outpatients from 2016 to 2022. Data were classified by the Anatomical Therapeutic Chemical system, expressed as defined daily doses (DDD) and aggregated by prescription month, patient age, sex and residency inside/outside a NH. The number of ensured beneficiaries, aggregated by the same demographic variables, was collected from the Intermutualistic Agency. We compared the DDDs per 1,000 beneficiaries per day, along with secondary metrics for national and international targets for analogous populations inside and outside NHs.ResultsTotal antibiotic consumption decreased in both populations but remained twofold higher in NH residents. Proxy prescription quality metrics were consistently less favourable within NHs and diverged further during the COVID-19 pandemic. Distinct consumption patterns and greater seasonal fluctuations were observed in NH residents.ConclusionGiven the different infection risks and higher antibiotic consumption of NH residents, AMC surveillance and antimicrobial stewardship efforts targeting this fragile population are needed.

Resilient supply chain operations following major disturbances: lessons from COVID-19 cases

Resilience has become a major concern to the global supply chain after the COVID-19 pandemic. Although the pandemic is hopefully tailing off, this study remains essential for future preparedness against major disruptions in global supply chain operations. This paper extends the Public-Health Corridors (PHC) concept from international travel coordination to global supply chain operations, with the underlying goals of reopening borders and alleviating social and financial burdens. Very little has been learnt from and very few guidelines are provided for developing PHC that recovers supply chain operations. This research fills this research gap by providing the architecture of PHC. Game-theoretical models with a strategic government-private-public-partnerships (G3P) mechanism are proposed to demonstrate how effective PHC can establish a new norm for social and economic activities under COVID-19 with minimal additional burdens. It offers theoretical evidence for possible approaches that facilitate effective stakeholder collaboration in launching PHC. Findings show that the implementation of basic PHC can resume supply chain operations through appropriate PHC measures and investments, while a well-designed G3P mechanism significantly bridges the gap between new norms and pre-pandemic conditions. A targeted subsidy programme is crucial for profitability, and well-crafted contracts are essential for achieving Pareto improvement and reducing required subsidies.

Progress Toward Measles Elimination - Worldwide, 2000-2023.

Measles vaccination effectively prevents measles, a highly contagious disease that can cause severe complications and death and requires high population immunity to interrupt transmission. This report describes measles elimination progress during 2000-2023. During 2000-2023, an estimated 60.3 million measles deaths were averted by vaccination. However, despite commitment from all six World Health Organization regions to eliminate measles, no region has successfully achieved and maintained measles elimination as of the end of 2023. During the COVID-19 pandemic, estimated global coverage with the first dose of measles-containing vaccine (MCV1) declined to 81%, the lowest level since 2008. MCV1 coverage improved to 83% in 2022 but was unchanged in 2023. From 2022 to 2023, estimated measles cases increased 20% worldwide, from 8,645,000 to 10,341,000; the number of countries experiencing large or disruptive outbreaks increased from 36 to 57. Estimated measles deaths decreased 8%, from 116,800 in 2022 to 107,500 in 2023, primarily because an increased number of cases occurred in countries with lower risk for death. The stagnation in MCV1 coverage means millions of children remain unprotected, leading to increases in cases and outbreaks. Coverage with measles-containing vaccine (MCV) is lower, and measles incidence is higher, in low-income countries and countries experiencing fragile, conflict-affected, and vulnerable settings, which exacerbate inequities. Urgent and targeted efforts are needed to ensure that all children receive 2 MCV doses and that surveillance is strengthened to hasten progress toward measles elimination.

Subjective well-being and mental health during the COVID-19 pandemic in Hungary

Purpose This study aims to examine the impact of COVID-19 pandemics on subjective well-being (SWB) and mental health in Hungary, with a particular focus on the roles of socioeconomic and COVID-19-related factors in shaping these outcomes. Design/methodology/approach A cross-sectional online survey was conducted among 2,000 Hungarian adults from May 25 to June 8, 2021. The data was collected using standardized questionnaires, including the SWLS, GAD-7 and PHQ-9. Correlation analysis, one-way ANOVA and linear regression were used. Findings The study found significant anxiety (41.5%), depression (48.1%) and life dissatisfaction (41.9%) among 2,000 participants. Females reported higher anxiety and depression than males. Single individuals had the lowest life satisfaction. Higher income levels are correlated with greater life satisfaction. Quarantine and vaccination were linked to higher life satisfaction and lower psychological distress. The regression showed that older age, being married and higher income were linked to lower depression and anxiety. Severity of infection and quarantine increased both depression and anxiety. Infection reduced life satisfaction, but severe cases showed a slight improvement in satisfaction, highlighting complex health and well-being relationships. Practical implications The findings reveal complex relationships, including unexpected resilience in severe COVID-19 cases. Originality/value This study offers insights into the impact of the COVID-19 pandemic on SWB and mental health in Hungary. By analyzing socioeconomic, demographic and pandemic-related factors in a large sample, it highlights complex relationships between quarantine, infection severity, vaccination and well-being. The findings contribute to understanding how these factors influence mental health, informing targeted interventions during health crises.

Physician-scientists' perspectives on key factors, emotions and feelings about selecting and attending continuous professional development events: a mixed-method study.

Almost 40% of the Nobel-Prize-winning discoveries in medicine are made by physician-scientists, who are a driving force in the evolving medical, academic and research landscape. However, their training has few defined milestones. To be effective clinicians, educators and researchers, they need to maintain and hone skills, often via continuous professional development (CPD) activities covering different domains. They have recurrently been described as an endangered species. Yet, warnings and recommendations across several decades did not stop the declining number of physician-scientists, which is now a chronic issue. This is further exacerbated by a lack of resources and support, especially after the COVID-19 pandemic. We administered a questionnaire called Positive and Negative Affect Schedule (PANAS-GEN) to get an initial emotional snapshot before performing individual semi-structured interviews with five physician-scientists in neurology working in the United Kingdom. We explored the key factors they balance before selecting CPD activities, along with their views on compulsory CPD events and assessments. We investigated their general feelings towards compulsory and non-compulsory CPD, how they felt the night before and the morning of the events, and the perceived consequences attending these have on their learning. In our study, physician-scientists tend to choose training in their area of expertise but would enjoy exploring more if they had more time. The CPD choice was chiefly driven by speakers and topics, followed by learning needs. They disputed the utility of the current assessments, which are often seen as box-ticking exercises. While frustration, hostility and negative feelings were voiced for the compulsory ones, other CPD activities were welcomed with excitement, curiosity and a sense of adventure. Enthusiasm and excitement were felt the night before and the morning of the non-compulsory ones. CPD events were perceived to positively affect further learning, with the most immediate consequences being reading an article, networking or interacting with the speakers. This is the first study exploring the key factors driving a group of physician-scientists while selecting CPD activities and investigating their feelings and emotions related to CPD attendance. More engaging and less box-ticking CPD should be on the cards, along with an adequate evaluation of these activities. It is essential to increase enthusiasm, which can facilitate engagement, and decrease frustration surrounding compulsory CPD activities. We still know too little about the role of emotions in learning, especially about CPD. Future studies should investigate the emotional side of learning across different career stages to restore the leaky pipeline and create a tailored environment with benefits for each of the three sides of the physician-scientist's identity: the clinical, the research, and the academic.